The Reverse Mullet Healthcare Podcast
Ellen Brown, Justin Politi, and Dave Pavlik bring their 90 collective years of healthcare experience to BP2 Health where they're on a mission to effect real change in the industry. Connect with BP2 Health Here: https://bp2health.com/contact/
The Reverse Mullet Healthcare Podcast
How would you spend $1B to fix healthcare? with Lee Bowers
On the Road Edition - Live at ViVE, Episode 6
Ever wonder how you would spend a $1B check to fix healthcare? We sat down for a speed session to hear Lee Bowers, President of Florida Blue Medicare of how he would use the $ to effect REAL change in healthcare.
We delve into transformative ideas discussed at the VIVE conference, particularly focusing on the groundbreaking potential of a universal EMR system. Lee also shares insights on the ongoing efforts to implement such a system within the military, exploring how these changes could enhance patient care and streamline billing processes. Additionally, Lee shares the idea of creating a universal Medicare Advantage provider database.
Adding a dash of fun to cap off our episode, we share a hilarious interlude with Lee and Ellen both donning reverse mullet wigs. The audience can decide who wore it better. This playful segment captures the laughter and camaraderie of the moment, revealing the amusing challenges of hearing through a head full of hair. It's a delightful break from the serious discussion, showcasing a lighter side of our guest. We wrap up with heartfelt thanks to Lee for making this episode not only informative but also incredibly entertaining. Don't miss out on this unique blend of insightful discussion and sheer fun!
I am Ellen Brown with the On the Road edition at Vibe for the Reverse Mullet Healthcare Podcast. We are on day three, so I'm a little bit loopy, yep, and I'm here with I'm.
Speaker 2:Dave Pavlik.
Speaker 1:And we are here with Lee Bowers, which we have known, lee, for a really long time.
Speaker 2:Super excited to talk to Lee.
Speaker 1:Yeah, and it's super fun to have him on the show. We haven't had him on the show yet, so, lee, tell us why you're here at Vive.
Speaker 3:I'm here at Vive to meet a whole lot of people.
Speaker 1:It's a great conference and I happened to be I was asked to participate in a panel discussion yesterday about dual eligibles and D-SNP plans, which you know nothing about. I'm learning. I guess by now you might know a little something. It's been a 15 year build up and I'm learning. I'm learning. I guess by now you might know a little something.
Speaker 3:It's been a 15-year build-up and I'm still learning.
Speaker 1:Yeah, so tell us about your role and where you came from, because I know you're in a new role.
Speaker 3:I'm in a new role. I'm now the president for Florida Blue Medicare. Prior to that, I was with a company called Centene A little company.
Speaker 1:Just a small little place.
Speaker 3:So I was with WellCare when Santine acquired WellCare and so I stayed on and was helped, was part of the leadership team that ran our Florida operations, our Florida market, and so we had significant market presence. One point eight million Medicaid lives. You had about one hundred and fifty thousand Medicare and and in the marketplace we're hovering around 500, between 500 to 700 depending on what time frame. So I and everything was going great. We actually were going for the RFP and Medicaid which you know, through last year in this year but I decided to step over to Florida blue Medicare. I've really had a lot of respect for what they're doing and just very exciting yeah, they have a lot of opportunity.
Speaker 1:I mean they're doing and just very exciting. Yeah, they have a lot of opportunity. I mean on our consulting side we have done a lot of work in Florida with a lot of Medicare folks.
Speaker 3:And.
Speaker 1:Florida Blue is always one of those where we're looking at markets. We're like man. They just haven't tapped into the opportunity and the potential here yet, so I'm excited for you.
Speaker 3:I am excited. They've done amazing things with some of the GuideWell assets, with Sanitas and with, you know, a couple of the other provider clinics. They've done amazing things on the commercial side and we're doing starting to do amazing things on the Medicare side.
Speaker 1:Well, we are excited to watch that journey, so absolutely. We are here to ask our guests the big question, which is how? What do you think could affect real change in health care? All caps.
Speaker 2:Can I ask him?
Speaker 1:Yes, Do you want to ask?
Speaker 3:Hey, Lee are you going to say it really loud? What do you?
Speaker 2:think can affect real change.
Speaker 3:All caps, all caps real change in health care. I think a universal EMR some way of setting up a universal. Emr, where every single record is locatable. Every single member, patient person who's being served by a physician, any physician at any time, any provider at any time, any home health agency at any time, any hospital at any time has access. Has access, yes, and can pull it. And can pull it real time and then provide uh, provide the billing and coding and other information real time back into this giant record.
Speaker 2:So wouldn't that be amazing? I feel like we've been talking about that for decades. Yes, but you know who?
Speaker 1:I'm going to call out James Nichols on this, because because James last night was offering a billion dollars, right? Do you remember this? He was like if you could spend a billion dollars as a health plan CEO, where would you spend your money? And Lee's answer was infrastructure. And I thought, as you're saying this, I'm tagging James, who we plan to have on the on the podcast in the future, anyways, but that to me.
Speaker 2:there you go, james Does he actually have a billion dollars to give.
Speaker 1:He is on the equity side of things and he has some really interesting thoughts around healthcare as infrastructure.
Speaker 3:And this.
Speaker 1:I think we your answer. It goes directly to to to James's point, which is there are infrastructure plays that are needed in the healthcare space and I think the universal EMR that you're talking about, lee, is squarely in that idea, right.
Speaker 3:Absolutely. It's the one thing that we're all striving, you know like we're all striving to make it a little more consistent and to payers, and payers and providers are all trying to get there. But I'm talking about, you know, real change, and so we can tell. James Nichols, I've got a routing number that I can give him.
Speaker 2:He's on his way. We texted him to bring his checkbook.
Speaker 3:Yeah, we did so he'll love the idea, though, that that would be real change. The organization that can get us there will be the organization.
Speaker 1:I think that really can kind of save health care in a way.
Speaker 2:Yeah, I agree, you know a friend of mine works for the government or a government contractor. One or the other is bouncing back and forth, but he's been working on a universal medical record for the military.
Speaker 1:So all veterans.
Speaker 2:They've been working on that for 10 plus years. He's been on that project for 10 plus years still not done. And that's a small part of the population, so it's a big, big task.
Speaker 1:I like this answer I like it Very good I like it a lot, all right. Well thank you, Lee I have one other. Oh man, this is great, keep going.
Speaker 3:So this is a smaller change, but I'm thinking about it from a Medicare perspective. So Medicare for the Medicare population, have a universal database with all providers. Have like a single provider directory.
Speaker 1:Of all Medicare.
Speaker 3:participating providers Of all Medicare participating providers, medicare participating providers, and and so, and put the put the onus of the accuracy on back. You know like, make it universal so that all of us plans are not doing the same thing we all have at least.
Speaker 3:We might not have the same providers in network, but we'll have the same listing that's brilliant. The same tax ID number with the 10 MPIs, and when a provider provides, physicians tend to travel around health system to health system. So, and all of us plans don't keep up with it, great, we send our own set of information.
Speaker 1:We send very diplomatically.
Speaker 3:I was going to ask you, we don't all do it great we also, we're depending on the health systems a lot of times to send us back a roster right, exactly, they could do that once, they could do that twice. They're doing it 10 times for 10 different health plans in 10 different formats.
Speaker 1:Age, old problem. See, we don't need, we don't always need to focus on the shiny objects.
Speaker 2:No, exactly Correct, but I I suppose you expect it to be accurate and current too.
Speaker 3:Yes, accurate and current. Yeah, I like it. I think that would be great. And then would you Talk about great member experience. It's great, absolutely.
Speaker 1:And then would you in that master database would the providers have the ability to put in Like would you envision Now I'm really thinking out loud here. I love these spitball sessions right? So would you? How would the health plan participation in credentialing like? Is that something that would happen at that master level?
Speaker 3:It would happen at the master level. Okay, credentialing, unless a health plan decided they wanted to, you know, have some kind of more onerous credentialing requirements but have some certain level of credentialing that CMS requires and that we all agree on, and then you've got a master database. People you know, the only thing that the health plan then would be responsible for then this is a big responsibility is absolutely making sure that the accuracy of their participating providers out of that, big database.
Speaker 1:Gotcha, I gotcha, it's a big task.
Speaker 2:It's a big task. Yeah, but that's a great. Doesn't seem like it should becha. It's a big task.
Speaker 1:It's a big task, that's a great doesn't seem like it should be, but it's a big. I love these two. I really. I mean this not just because we're friends. I really like the brass tacks nature of these answers yes, they're fantastic.
Speaker 3:It would be. Fan it. It was something that we've um. I'd like to anyway. I think it'd be something great to take to CMS and say hey, here's a really good idea.
Speaker 1:I smell a full episode. I really do, and I'm not just saying that, just on these topics, I do. I think it would be fantastic Because we haven't done that Near and dear to my heart.
Speaker 2:We've been dealing with provider data forever.
Speaker 1:Oh no, he's going to put on the mullet, are you really he's going?
Speaker 3:to do it too he couldn't help himself.
Speaker 2:Look at that. Oh my gosh, I'm doing it too. He just couldn't help himself.
Speaker 3:I can't even hear through the hair.
Speaker 2:Okay, there you go All right. Lee, thanks so much for stopping by. Thanks so much for stopping by.
Speaker 1:Leave hours. I got my wig on too.
Speaker 2:Thanks so much for stopping by. Thank you guys Appreciate it. Thank you, lee Okay bye, Leave the.
Speaker 1:Yeah, we got to go Take care.